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Wednesday, 11 December 1974
Page: 3375

Senator GUILFOYLE (Victoria) - Mr Deputy President,may I suggest that the Health Insurance Levy Assessment Bill 1974 (No. 2), the Health Insurance Levy Bill 1974 (No. 2) and the Income Tax (International Agreements) Bill 1974 (No. 3) be dealt with in a cognate debate as they are related matters?

The ACTING DEPUTY PRESIDENT (Senator Marriott)- Is leave granted? There being no objection, it is so ordered.

Senator GUILFOYLE - The 3 Bills to which I have referred are levy Bills which will provide funds for the Hayden health scheme. They cover proposals which have already been debated in the Senate this year and which were rejected by the Opposition. The attitude of the Opposition can be stated quite briefly: It totally rejects the 3 Bills concerned. It will be recalled that last week we amended the National Health Bill (No. 2). We amended it so that we could reject the provisions which had been made with regard to the control of voluntary health funds. We regarded these proposals as an attempt to ruin the voluntary health funds in Australia and as a first step towards the introduction of the costly and compulsory tax financed system of nationalised health care.

Evidently the Government is determined to ignore the many adverse reactions which have been expressed about its scheme. I refer to some of them. I have before me a Press statement which was released on 8 December this year by 3 groups in the community- the doctors of the medical profession, the private hospitals and the health benefit funds. It will be realised that the co-operation of these 3 groups is essential if the Australian Government's health scheme is to be successful. These groups have confirmed their opposition to the scheme. They also felt they should state that they think it is indefensible that the Government should plan to spend $1.58m on a campaign to promote the scheme, the objective of the campaign clearly being to urge the Australian people to accept the scheme. The professional bodies I have mentioned have rejected it. The most recent poll conducted of the Australian people showed that 56 per cent of the voters want to pay their own way and reject the concept of a compulsory health scheme as has been outlined by the Government.

There are other matters that I think should be stated and recorded at this time. In particular, I am indebted to a very thoughtful speech delivered by Professor Richard Downing, the Ritchie Professor of Research in Economics at the University of Melbourne, and Chairman of the Australian Broadcasting Commission, in Melbourne on 21 November. In it he put forward some thoughts which should be considered by the Australian people when they are contrasting the present scheme, which is based on voluntary contributions, and the proposed Hayden health scheme. Professor Downing talked about 3 government proposals which need to be looked at when we are talking about the commitments that the Government is taking on behalf of the people. He spoke of the Woodhouse compensation scheme, which is being dealt with by a committee of the Senate at this time, the Hancock superannuation scheme and the Hayden health scheme.

He indicated that the concepts involved in those 3 schemes would entail a total expenditure of something like $4,900m, which is about 10 per cent of the gross domestic product of this country. Allowing for the fact that governments are already spending about $2, 100m on some of those areas the additional cost would be $2, 800m, which would represent an increase of 5.7 per cent of the gross domestic product. Of this new expenditure 1.4 per cent is to be raised from general tax revenues and 4.3 per cent through contributions by beneficiaries. It is interesting to note that the additional burden will fall mainly on the lower income people who are not now contributing to a private health fund scheme. The 3 proposals would increase the flow of funds through public accounts from 32.5 per cent of the gross domestic product to 38.2 per cent. That increase would mean that taxation in this country would need to be increased from 22.3 per cent to 28 per cent on present rates. It is extraordinary to think that there would have to be an increase from 22.3 per cent to 28 per cent to finance schemes which are imposed by the Government upon the people.

It seems to me that we should remind the people of Australia that when they are thinking of these new proposals which have been offered to them they should also take into consideration that it is they who will be paying for them. They have not been offered to the people by the Government at a cost to the Government; rather they will be imposed upon the people by the Government at a cost to the people themselves. The people will have to pay for what may in some cases be desirable schemes but what will certainly be costly ones. That speech by Professor Downing is, I think, timely at this juncture because it is the costs that we must consider when we are looking at the economics of our country at this time and the responsibility that we will have for programs that are decided and imposed upon the people by the Government.

One thing that we ought to do in relation to the present debate about the health care scheme envisaged for this country is to ask ourselves some questions. Perhaps it is not a matter of asking ourselves whether there should be a scheme of medical and hospital insurance but really of asking ourselves what sort of scheme there should be. I think that those are the things which have been outlined repeatedly by the Opposition. They are matters which we feel that we need to assert again. It is not a matter of saying that we do not believe that there should be a health care scheme or that there should be some scheme which will involve the people in health care and in the arrangements which relate to it but rather a dispute about the means of providing health care. We ask: Should it be a government sponsored compulsory scheme or should there be a situation in which people have some choice and exercise that choice and accept some personal responsibilities? So it is really a debate about the means of proceeding and the way in which to proceed towards obtaining health cover for all the Australian people and the acceptance of what I think both the Government and Opposition see as a goal- the provision of health care.

The Minister for Social Security, Mr Hayden, has persisted in his contention that this government scheme is the best way in which health care can be provided. We challenge that. We regret the fact that Mr Hayden sees fit to criticise those who are opposed to his scheme and to say that there is deliberate deceit and misrepresentation of his scheme. For some time we have been considering the plans which he has had. At no time have we been able to consider the actual cost of his scheme or many of the provisions which need to be considered by people. But it is fair to comment on some things that we do know about his scheme. One of them relates particularly to hospital care, that is, the government subsidy which has been provided for in the government scheme- a subsidy to pay private hospitals $16 per day for each bed used. This has been offered as a means to help citizens to meet the cost of hospitalisation in these institutions. But we have to comment that the $16 per day bed subsidy would cover less than one-third of the hospital cost.

Then we have the difficulty of ascertaining why the amount of $16 has been written into the legislation. Why is it that the Government will not accept a proportion or some amount that can be varied to take into account the variance in cost and in the inflation which we experience? The fact that we see the $16 written into the legislation makes us feel that there will be a tremendous gap between what the Government will give by way of support and what the people will be expected to pay on current costs. The Government has repeatedly said that it does not want to abolish the private hospital system, but we have to say that it gives no undertaking that it will preserve the private hospital system or that it will allow the system to continue with the support that it has had from the voluntary system which is at present in operation.

It is important again to remember that the Bills before us provide for a levy of 1.35 per cent of taxable income. But that 1.35 per cent tax will provide only for standard public ward bed care, if hospital care is the matter which is under consideration, and any extra amount that is required if private hospital care is chosen would be subject to a separate payment and separate insurance would need to be undertaken by the individual. I think it is not hard to see that people in the lower and middle income groups will have no choice as to what type of hospital care they will have in future because a payment of a compulsory levy for the government scheme and an additional private contribution would place the cost of such care beyond their reach. Therefore the removal of private hospital facilities will be very much the experience of those people who are not in the higher income groups. The effect of this, of course, will be that the private hospitals themselves will be in difficulties because there will not be the support for them from the community that they have experienced in the past.

The Government has repeatedly talked about the economics of the health scheme which it has introduced. We have to question whether that is the only measure that should be placed on such a matter of personal care that is needed in our community. We regret that it has been said that the economic factors are important to the extent that has been shown by the Government's scheme. We would also like to point out that we believe the Government's scheme will be a very costly one in terms of administration and efficiency. We consider that it is inadvisable to implement this scheme in the present economic climate having regard to the inflationary effect that will undoubtedly occur through the public expenditure involved. It is an economic fact of life that large scale government programs in any service are inflationary and difficult to undertake at the present time. They place added responsibility on us when we are considering the effective use of our resources. The lack of restraint in government spending on public hospitals will help to push upwards medical costs in general. We consider that this is another undesirable feature.

Sitting suspended from 1 to 2.15 p.m.

Senator GUILFOYLE - Prior to the suspension of the sitting for lunch I was finalising my remarks on the 3 health Bills which are before the Senate. I had referred to the difficulties of private hospitals. I want now to refer to the difficulties that a free health scheme produces. The difficulties caused by over-use of such a scheme have been recognised in all of the countries where it has been introduced. The experience in Canada with a government sponsored universal and comprehensive system has been that the demand for health services generally exceeded the supply. We believe that this would be inevitable in Australia. The details of the Government's scheme which have been given to us lead us to believe that the private hospitals would be endangered in their continuity, and undue demands would be placed upon all of the facilities available to us.

I think it fair to summarise the Opposition's attitude in this chamber as being the same as that expressed by the shadow Minister for Social Security in the other place when dealing with the health levy Bills, namely, that we believe our alternative health scheme would be preferable for the Australian community. In the other place we took the opportunity to have details of that alternative scheme included in the Hansard report of the debate and I do not wish to restate it at the present time. Our scheme is based on voluntary contributions to the private health funds, maintenance of the private hospital system and a further development of cover for the some 8 per cent of people in this community whom we believe have not at this stage arranged their own private health insurance. It is for those reasons that the Opposition in the Senate will continue with the approach we have taken since this scheme was introduced, that is, to reject the Government's measures. The Opposition Parties will reject the 3 Bills we are considering in the hope that eventually the Government will understand that its scheme is uncosted, inadequate and undesirable for the Australian community.

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